Priority domains, design and contextual considerations for a rehabilitation program addressing the daily living...

People diagnosed with borderline personality disorder (BPD) experience persistent functional impairment, yet no manualised rehabilitation program addressing daily living functioning currently exists, creating opportunity for program development. This study aimed to identify: 1) priority domains of daily living functioning to include in a rehabilitation program, and 2) how such a program could support functional recovery.

Five focus groups using a modified nominal group technique captured consumer (n = 9), caregiver (n = 7), mental health clinician (n = 3) and occupational therapist (n = 5) perspectives. Priority domains were ranked to structure discussions. Transcripts were analysed using conventional content analysis.

Seven priority domains were identified: 1) Finding purpose and identity through roles, values and milestones; 2) Sleep and energy management; 3) Coping strategies to support emotional regulation; 4) Relationships, social connection and interpersonal skills; 5) Structured routines and balanced living; 6) Self-care, household and financial management; and 7) Help-seeking and self-advocacy. Participants envisioned a modular, graded program adjunctive to psychotherapy, addressing foundational domains before values-aligned roles. Design considerations included caregiver involvement, facilitator training, and responsiveness to stigma and comorbidities.

Findings provide priority domains, design and contextual considerations to inform co-production of a rehabilitation program.